Multiple Symmetric Lipomatosis (MSL), also known as Morbus Madelung or Launois-Bençaude disease, is a benign condition characterized by symmetrical growth of non-encapsulated adipose tissue. Initially described in 1846, MSL typically presents with distinct fat distributions, notably in the neck and upper body. Classification systems have evolved, with various subtypes documented based on fat accumulation patterns. The etiology remains unclear, but hypotheses suggest links to mitochondrial mutations, inflammation, chronic alcohol consumption, and lymphatic changes. Diagnosis primarily relies on clinical evaluation supplemented by imaging techniques. Therapeutic approaches include conservative management, surgical options such as liposuction or lipectomy, and emerging treatments like rapamycin. Recognizing the significant impact on patients’ quality of life is crucial for effective management. Further research is needed to elucidate the pathophysiology and optimize treatment strategies for MSL.